In a nutshell

This study examined the long-term outcomes of women who underwent tension-free vaginal tape-obturator (TVT-O) for stress incontinence. The authors determined that TVT-O was very effective in the long-term and was a safe option for the treatment of stress incontinence.

Some background

Vaginal sling procedures are the most common type of surgery used to help control stress urinary incontinence. The transobturator tape (TOT; also sometimes known as TVT-O) approach is a minimally invasive vaginal sling procedure. It is a widely adopted approach that involves the placement of a narrow mesh tape underneath the urethra (urine tract). This helps lift the urethra to its normal position and close more tightly.

Five-year outcomes after TVT-O have shown it to be safe and effective. One study noted cure rates of 81.5% to 83.5% after 7 years. The long-term outcomes of TVT-O are still under investigation.

Methods & findings

This study examined 10-year outcomes of women who underwent a TVT-O. 160 women were assessed at 5 and 10 years. At follow-up, patients underwent a stress test to measure urine leakage. They also completed questionnaires on how they viewed their outcomes following TVT-O.

There were no significant changes in outcome over the follow-up period. 97% of patients reported themselves cured at 10 years. 92% of patients were considered cure based on urine leakage during a stress test. Patients who had failed at previous treatments for stress incontinence were 5.34 times more at risk of TVT-O failure.

14% of patients reported overactive bladder symptoms at 10 years. No other new complications were reported.

The bottom line

This trial concluded that TVT-O was a safe and effective treatment in the long-term for stress incontinence.